Gavin Ferguson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6948 Issued in AZ

Practice address

1515 E Cedar Ave Ste 2B3B4E12
Flagstaff, AZ 86004-1600

Phone

(928) 714-0010

NPI assigned

Oct 17, 2017

Last updated

Sep 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Institute for Liver Health, LLC

  dba Arizona Liver Health

  • Hepatology Physician
  • Chandler, AZ
  • NPI 1831603505
  Medicare reassignment
• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389
  Medicare reassignment
• Southwest Behavioral Health

  • Psychiatric Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1659380780
  NPD
• Southwest Behavioral Health Services, Inc.

  • Psychiatric Residential Treatment Facility
  • Kingman, AZ
  • NPI 1023556339
  NPD
• Southwest Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1023023603
  NPD (past)
• Southwest Behavioral Health Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flagstaff, AZ
  • NPI 1316170368
  NPD (past)
• Southwest Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Prescott Valley, AZ
  • NPI 1578844726
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1265943252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 S GILLENWATER DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860058983",
            "telephone_number": "928-600-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E CEDAR AVE STE 2B3B4E12",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041600",
            "telephone_number": "928-714-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "GAVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6948",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Jay Felsted, D.O.
• Sheryl Felts Hanno, RPH
• Joselyn Sturgis Fenley, MOTL
• Kathryn Fenster, LPC
• Alexander John Ferda, CRNA
• Liana Fernandez Garcia
• Rafael Arnoldo Fernandez, MD
• Elizabeth Anne Feroz Marano, DPT
• Derek M Feuquay, M.D.
• Kathryn Neilla Feuquay, MD

• Physician Assistant in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.